Frontline: Psychoanalysis in the Closet or a New Beginning?

Recently, a physician colleague requested a psychiatric referral for himself. Knowing something about his problems, I suggested a psychoanalyst. His reply was that everyone knows that psychoanalysts are “crazy.” He learned in medical school that they are preoccupied with sexual issues and only likely to add to one's problems. Soon after, I asked a well-known psychoanalyst colleague on the East Coast what physicians in his city thought of psychoanalysts. He replied that they are “considered crazy at best and charlatans at worst.” Of course, we can rationalize these comments by saying they are overgeneralizations, but my observations over thirty-six years of medical practice is that psychoanalysts have a public relations problem somewhat worse than snakes. We need to see this changed.

When I was a young student, psychological testing, especially projective testing, was considered part of the psychoanalytic armamentarium. I recall lively discussions with two prominent psychologists, both psychoanalysts (one an Academy member), about the integration of psychological testing with psychoanalytic clinical observations. What happened? With the passage of time and growing indifference on the part of psychoanalysts, nonpsychoanalytic psychologists and counsellors have taken psychological testing as their own domain, showing remarkable marketing and revenue-producing talents. Often, they refuse to release the raw test data to physicians and instead use it to produce clinical diagnoses devoid of developmental and medical understanding. It is no surprise that nonmedical people are now permitted to write prescriptions in certain states. Make no mistake, my focus is not on the